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- Sharon
- Kummerer
- 1401 South California Boulevard
Chicago
Illinois
60623
United States - Schwab Rehabilitation Hospital
Chicago
Illinois
60623
United States
As an early intervention SLP, I adhere to a combined play-based language and motor learning approach to intervention for children with CAS. The children's specific diagnostic treatment programs are individualized and co-constructed with their families. Using play-based language therapy and integral stimulation techniques, I incorporate the four tenets of cognitive motor learning into therapy (e.g., precursors to motor learning, conditions of practice, feedback, and influence of speech rate). Integral stimulation includes the identified speech targets and requires the children to imitate utterances (e.g., syllables, words, or phrases) modeled by the clinician and/or mother in a "look, listen, do what I do approach."
In general, mass practice of targets are done in predictable blocks with lots of cues for newer items and distributed practice in less predictable order for items that are improving. Multi-modal cues including auditory, visual, and tactile input are provided (along with integral stimulation and Dynamic Temporal & Tactile Cueing) with cues faded across time. I model multiple repetitions of the treatment targets using cognitive motor learning principles to stabilize the motor plan and establish motor learning versus motor performance .
Language therapy with the children and their families follows the interactive model and strategies inherent in The Hanen Program® for Parents. The SLP discusses applicable strategies, and practice techniques during treatment sessions. I also foster literacy modeling, opportunities, and interactions (including phonological and phonemic awareness) between parents and their children.
Through frequent sampling of the children's productions during treatment (and at home) and analysis of case-based cumulative criteria, therapy plans are modified to respond to changes in the children's speech motor abilities and performance capabilities. Individual programs ultimately reflect the children's current speech and language skills and focus on increasing their functional ability to communicate across contexts.
Parents arrive with their preschool-aged children one time weekly for 45 minute treatment sessions. Many families can only come one-time weekly to our clinic due to insurance authorizations, work commitments, childcare for siblings, and need to take public transportation.
Parents are involved in each step of the therapy process. For example, parents at our outpatient clinic: (1) provide a description of their child's speech and/or language challenges, (2) assist in identifying initial targets that are phonetically simple and highly functional to maximize their children's early success, (3) participate in therapy sessions- observing the SLP, practicing principles of motor learning, and receiving feedback along with their children, (4) identify activities and strategies for generalizing treatment strategies during home routines.
Throughout their children's treatment programs, I encourage parents to record gestures, words, and phrases that their children are attempting in the home setting and then target those utterances during play-based activities using integral stimulation and DTTC techniques. I provide parents with information from the Apraxia Kids website (in both English and Spanish) to better understand the CAS diagnosis and evidence-based treatment plan.
My main goal is to empower parents to continue treatment techniques during home activities and become their children's primary language facilitators. I bring to parents' awareness those practices that they already use that are helpful in facilitating their children's communication (e.g., modeling words and phrases, encouraging multiple productions of a phrase or verbal script, and/or praising their children's communicative attempts.
Families are invited to borrow toys, materials, and books from the clinic for implementation in their homes. In a similar manner, parents are encouraged to share communicative routines and activities practiced in their homes for use in the clinic.
Describe (briefly) how you have used AAC: I have mainly used low tech AAC options. For example, the children's individual speech targets and functional phrases are continuously paired with PCS via the Boardmaker® program. I complete a core communication book for young children with the CV, VCV, CVC, and CVCV words they are attempting to produce and then laminate and insert picture targets into home binders for practice outside of treatment.
As targets move to increased levels of accuracy and stable motor plans are established, I encourage families to elicit the targets on a daily basis and increase the complexity of the target by adding syllables, carrier phrases, verbal scripts, and eventually incorporating more structured work on prosody and speech rate through sentence and story building.
